New Concept of and Approach to Clubfoot Treatment

The second section of three on the new concept of and approach to treatment of clubfoot presents a radically new method of correction of the abnormal subtalar rotation presented in Section I. The nonoperative and operative approach is based on applying pressure in the opposite direction. Thus, the calcaneus and cuboid are pushed laterally anterior to the ankle joint and the calcaneus is pushed medially toward the medial malleolus posterior to the ankle joint. A detailed description of the surgical technique, including a method of maintaining flexor tendon function and protection of ankle joint from fibrosis, and postoperative treatment, including a new method of obtaining early joint motion, is given. Indication for flexor hallux longus transfer to improve peroneal longus function, particularly with previously failed surgical correction, is also described.